Provider Demographics
NPI:1174713655
Name:PARKVIEW HOSPITAL
Entity type:Organization
Organization Name:PARKVIEW HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-295-1000
Mailing Address - Street 1:2115 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-2109
Mailing Address - Country:US
Mailing Address - Phone:405-295-1064
Mailing Address - Fax:
Practice Address - Street 1:2115 PARKVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2109
Practice Address - Country:US
Practice Address - Phone:405-295-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1600438282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100089650AMedicaid
OK1600438OtherLICENSE
OK1600438OtherLICENSE
OKP35729Medicare PIN